iCan Dance Volunteer Registration Form

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Host name: Coastal Bringing Up Down Syndrome of Southeastern NC
Camp dates: December 19, 2022 - December 23, 2022
Camp location/address: Community Arts Center: Hannah Block Historic USO, 120 S. Second Street, Wilmington, NC 28401

We are pleased to offer this dance program to people with disabilities and look forward to having you play an important part in helping our dancers reach their goals.

***NO PRIOR EXPERIENCE WORKING WITH PEOPLE WITH DISABILITIES IS NECESSARY***

AGE REQUIREMENT: Volunteers must be at least 12 years old.
If you are under 12, please contact the Camp Host for possible opportunities.

For questions please contact Jessica Wilson at icandancewilmington@gmail.com

Volunteer First Name *

Volunteer Last Name *

Age at START OF CAMP *

YYYY

T-shirt size

XXL

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E-mail address *

Please ensure you have entered a valid email. The Camp Host will use this address when corresponding with you.

Cell Phone *

Please enter 10 digits

Home Address (Number and Street) *

Home Address (City) *

Home Address (Zip Code) *

5 digits only, please

Home Address State/Province *

Emergency Contact Name *

Emergency Contact Phone *

Please enter 10 digits

Parent/Guardian Email (if volunteer is under 18 y/o)

Please ensure you have entered a valid email. The Camp Host will use this address when corresponding with you.

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